May 16 2025 This Week in Cardiology

This Week in Cardiology

Medscape Podcasts

Cardiology, Science, Medicalpractice, Electrophysiologist, Medscape, Internalmedicine, Medicaldecisionmaking, Expertcommentary, Eartrhythmdisorder, Health, Perspective, Medicine, Healthnews, Medicalexpert, Endoflifecare, Clinicaltrials, Health & Fitness

4.9 • 876 Ratings

🗓️ 16 May 2025

⏱️ 29 minutes

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Summary

The BedMed trial of nighttime BP meds, SURMOUNT-5, Troponin URL, gene tests in patients with no disease, and guideline-directed medical therapy for HF are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I Timing of BP Meds – The BedMed RCT

MAPEC https://doi.org/10.3109/07420528.2010.510230
Hygia https://doi.org/10.1093/eurheartj/ehz754
Turgeon et al https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.16501
TIME trial https://doi.org/10.1016/S0140-6736(22)01786-X
BedMed https://jamanetwork.com/journals/jama/fullarticle/2833860
Time Antihypertensives Taken Doesn't Matter: New Trials https://www.medscape.com/viewarticle/time-antihypertensives-taken-doesnt-matter-new-trials-2024a1000g3z
Timing of BP Dosing Doesn't Matter: BedMed and BedMed-Frail https://www.medscape.com/viewarticle/timing-blood-pressure-dosing-doesnt-matter-again-bedmed-and-2024a1000fz2
Timing of Blood Pressure Meds Doesn’t Affect Outcomes: BedMed in Print https://www.medscape.com/viewarticle/timing-blood-pressure-meds-doesnt-affect-outcomes-bedmed-2025a1000cdm

II Tirzepatide vs Semaglutide

SURMOUNT 5 https://www.nejm.org/doi/full/10.1056/NEJMoa2416394

III Age-specific Troponins

Coyle and McEvoy https://doi.org/10.1093/eurheartj/ehaf308
Mandrola/Foy JAMA-IM https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2777967

IV Return to Play for Gene Positive Phenotype Negative athletes

Martinez et al https://doi.org/10.1016/j.jacep.2025.03.013

V Rapid Titration of GDMT in HF

STRONG HF: More Beats Less After Discharge for Heart Failure https://www.medscape.com/viewarticle/983698

JACC-HF Substudy https://doi.org/10.1016/j.jchf.2025.02.020
STRONG HF https://doi.org/10.1016/S0140-6736(22)02076-1
AVID https://www.nejm.org/doi/full/10.1056/NEJMoa013474
EAST https://www.nejm.org/doi/full/10.1056/NEJMoa013474

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Transcript

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0:00.0	You're listening to This Week in Cardiology from the heart.org, Medscape Cardiology.
0:05.7	This podcast is intended for health care professionals only.
0:08.8	Any views expressed are the presenters own and do not necessarily reflect the views of WebMD or Medscape.
0:15.6	Hi, everyone.
0:16.9	This is John Mandrola from the heart.org medscape cardiology, and this is this week in cardiology
0:22.9	for May 16th, 2025. This week, the bed med trial of nighttime blood pressure meds, the surmount
0:31.5	five trial, troponin upper reference limits, gene test in patients with no disease, and guideline direct to medical
0:39.7	therapy for heart failure. First topic is the timing of blood pressure meds. Jama has published,
0:47.6	what I hope is the last of the trials of timing of blood pressure meds. Here is a brief rundown
0:53.5	of the history. The MAPE-ac trial, MAPEC trial conducted
0:59.0	between 2000 and 2009, found a 61% reduction of maids favoring bedtime administration of blood
1:07.2	pressure meds. This was published in a journal called Chrono Biology International. I know.
1:13.6	I had never heard of it either. Then, the same group from Spain conducted the Hygia trial of 19,000
1:20.4	patients with hypertension, and they reported a 45% reduction in Mace with bedtime blood pressure meds.
1:28.4	The European Heart Journal published this trial in 2020, and it set off a storm of controversy.
1:33.8	The European Heart Journal editors even issued a formal expression of concern letter.
1:39.4	Ricky Turgeon and Canadian colleagues writing in the American Heart Association Journal hypertension,
1:49.1	noted that the main concern of many concerns with Higia was that nighttime blood pressure meds also reduced the risk of non-cardiolascular death.
1:54.7	This, they argued, was a serious outlier as no blood pressure trial had ever shown a reduction
1:59.1	in non-CV death.
2:01.4	Further, Terjohn at all noted that it was unclear whether or not Hygiea was truly randomized,
2:06.7	nor whether allocation was concealed.
	...

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